Echinococcosis is one of the 17 neglected tropical diseases (NTDs) recognized by the World Health Organization. The two major species of medical importance are Echinococcus granulosus and ...Echinococcus multilocularis. E. granulosus affects over 1 million people and is responsible for over $3 billion in expenses every year. In this minireview, we discuss aspects of the epidemiology, clinical manifestations, and diagnosis of cystic echinococcosis or cystic hydatid disease caused by E. granulosus.
The earlier recommendations of the WHO-Informal Working Group on Echinococcosis (WHO-IWGE) for the treatment of human echinococcosis have had considerable impact in different settings worldwide, but ...the last major revision was published more than 10 years ago. Advances in classification and treatment of echinococcosis prompted experts from different continents to review the current literature, discuss recent achievements and provide a consensus on diagnosis, treatment and follow-up. Among the recognized species, two are of medical importance –
Echinococcus granulosus and
Echinococcus multilocularis – causing cystic echinococcosis (CE) and alveolar echinococcosis (AE), respectively.
For CE, consensus has been obtained on an image-based, stage-specific approach, which is helpful for choosing one of the following options: (1) percutaneous treatment, (2) surgery, (3) anti-infective drug treatment or (4) watch and wait. Clinical decision-making depends also on setting-specific aspects. The usage of an imaging-based classification system is highly recommended.
For AE, early diagnosis and radical (tumour-like) surgery followed by anti-infective prophylaxis with albendazole remains one of the key elements. However, most patients with AE are diagnosed at a later stage, when radical surgery (distance of larval to liver tissue of >2
cm) cannot be achieved. The backbone of AE treatment remains the continuous medical treatment with albendazole, and if necessary, individualized interventional measures. With this approach, the prognosis can be improved for the majority of patients with AE.
The consensus of experts under the aegis of the WHO-IWGE will help promote studies that provide missing evidence to be included in the next update.
Abstract
Laser-wakefield accelerators (LWFAs) driven by widely available 100s TW-class near-infrared laser systems have been shown to produce GeV-level electron beams with 10s–100s pC charge in ...centimetre-scale plasma. As the strength of the ponderomotive force is proportional to the square of the laser wavelength, more efficient LWFAs could be realised using longer wavelength lasers. Here we present a numerical study showing that
$$10.6\,\upmu \hbox {m}$$
10.6
μ
m
, sub-picosecond CO
2
lasers with peak powers of 100–800 TW can produce high-charge electron beams, exceeding that possible from LWFAs driven by femtosecond near-infrared lasers by up to three orders of magnitude. Depending on the laser and plasma parameters, electron beams with 10s MeV to GeV energy and 1–100 nC charge can be generated in 10–200 mm long plasma or gas media without requiring external guiding. The laser-to-electron energy conversion efficiency can be up to 70% and currents of 100s kA are achievable. A CO
2
laser driven LWFA could be useful for applications requiring compact and industrially robust accelerators and radiations sources.
Identifying latently infected individuals is crucial for the elimination of tuberculosis (TB). We evaluated for the first time the performance of a new type of interferon-γ release assay, ...QuantiFERON-TB Plus (QFT-Plus), which includes an additional antigen tube (TB2), stimulating both CD4
and CD8
T-cells in contacts of TB patients.Contacts were screened for latent TB infection by tuberculin skin test, QFT-Plus and QuantiFERON-TB Gold in Tube (QFT-GIT).In 119 TB contacts, the overall agreement between QFT-Plus and QFT-GIT was high, with a Cohen's κ of 0.8. Discordant results were found in 12 subjects with negative QFT-GIT and positive QFT-Plus results. In analyses of markers of TB exposure and test results, the average time spent with the index case was the strongest risk factor for positivity in each of these tests. The difference in interferon-γ production between the two antigen tubes (TB2-TB1) was used as an estimate of CD8
stimulation provided by the TB2. TB2-TB1 values >0.6 IU·mL
were significantly associated with proximity to the index case and European origin.QFT-Plus has a stronger association with surrogate measures of TB exposure than QFT-GIT in adults screened for latent TB infection. Interferon-γ response in the new antigen tube used an indirect estimate of specific CD8
response correlates with increased Mycobacterium tuberculosis exposure, suggesting a possible role in identifying individuals with recent infection.
High-charge electron beams produced by laser-wakefield accelerators are potentially novel, scalable sources of high-power terahertz radiation suitable for applications requiring high-intensity ...fields. When an intense laser pulse propagates in underdense plasma, it can generate femtosecond duration, self-injected picocoulomb electron bunches that accelerate on-axis to energies from 10s of MeV to several GeV, depending on laser intensity and plasma density. The process leading to the formation of the accelerating structure also generates non-injected, sub-picosecond duration, 1-2 MeV nanocoulomb electron beams emitted obliquely into a hollow cone around the laser propagation axis. These wide-angle beams are stable and depend weakly on laser and plasma parameters. Here we perform simulations to characterise the coherent transition radiation emitted by these beams if passed through a thin metal foil, or directly at the plasma-vacuum interface, showing that coherent terahertz radiation with 10s J to mJ-level energy can be produced with an optical to terahertz conversion efficiency up to 10−4-10−3.
Human cystic echinococcosis (CE) is a parasitic infection caused by the larval stage of the tapeworm Echinococcus granulosus sensu lato, primarily affecting the liver and lungs. Although the heart is ...affected in only 0.02-2% of all CE cases, a considerable number of cases have been, and continue to be, published. However, due to the rare occurrence of cardiac CE and the resulting lack of clinical trials, knowledge about various aspects of the disease remains limited. To obtain a clearer picture of anatomical, clinical, diagnostic as well as therapeutic aspects of cardiac CE, we systematically reviewed the literature published between 1965 and 2022. The anatomical pattern of the affected cardiac structures follows the extension of the supplying capillary bed. The majority of patients (82.7%) are symptomatic and present with prolonged non-specific symptoms such as dyspnoea, chest pain and palpitations. Acute complications generally derive from cyst rupture, occur in 18.3% of cases and manifest as embolism, pericardial tamponade, or anaphylactic reaction in 83.2%, 17.8% and 10.9% of these cases, respectively. As for CE cysts localized in other organs, the diagnosis of cardiac CE is made by imaging. Serology plays a minor role due to its limited sensitivity. Unlike abdominal CE cysts, cardiac CE cysts are usually resected independent of their stage (active/inactive), because their presence impairs cardiac performance and carries the risk of long-term sequelae. More than 80% of patients are treated with a single surgical intervention. We found a disease-related case fatality rate of 11.1%. Since local recurrence was reported up to 108 months and secondary CE up to 72 months after surgery, patients should be followed up for a minimum of 10 years.
The radiation produced when an intense laser interacts with a solid target could provide a cheaper source of X-rays to synchrotrons and free-electron lasers. But they can also produce short bursts of ...gamma rays, whereas synchrotrons do not.
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